More work needed to stop youth tobacco use, U.S. Surgeon General says

Associated PressAn ashtray full of cigarette butts is shown in Omaha, Neb., in this March 28, 2007 file photo.

RICHMOND, Va. -- More work needs to be done to keep young Americans from using tobacco, including creating smoking bans and increasing taxes on tobacco products, the U.S. Surgeon General's office said in a report released today.

Almost one in five high school-age teens smokes, down from earlier decades, but the rate of decline has slowed, the report said.

It says it's particularly important to stop young people from using tobacco because those who start smoking as teenagers can increase their chances of long-term addiction. They also quickly can experience reduced lung function, impaired lung growth, early heart disease and other health problems like asthma.

More than 80 percent of smokers begin by age 18 and 99 percent of adult smokers in the U.S. start by age 26, according to the 920-page report, which is the first comprehensive look at youth tobacco use from the surgeon general's office in nearly two decades.

"In order to end this epidemic, we need to focus on where we can prevent it and where we can see the most effect, and that's with young people," Surgeon General Regina Benjamin said in an interview with The Associated Press. "We want to make our next generation tobacco-free, and I think we can."

The report details youth tobacco use, health impacts, and tobacco marketing and prevention efforts in the U.S. Officials hope the information will reinvigorate anti-tobacco efforts and spark public activism in reducing death and disease caused by tobacco use.

For Staten Islanders on the front lines of fighting against keeping young people away from smoking, the report affirms what they've been dealing with on a local level.

Adrienne Abbate, the manager for the Staten Island Smoke-Free Partnership, said, "The Surgeon General's Report serves as a confirmation to the importance of the Partnership's work in our borough. We, our community partners and elected officials throughout the Island are committed to the life-saving work of tobacco control. Of the 2,000 high school smokers on the Island, 1 out of 3 will die prematurely as a direct result of smoking."

Staten Island youth leader Carissa Mazzeo, a volunteer with Staten Island JCC Reality Check, said, "When I go into a convenience store, I feel like I have a target on my back. In-store tobacco ads are placed at kid eye level, often near toys, candy and snacks. Tobacco companies see me, and even kids younger than me, as their next generation of smokers."

The report also recommended anti-smoking campaigns and increased restrictions under the U.S. Food and Drug Administration's authority to regulate tobacco as other ways to prevent adolescents and young adults from using tobacco products.

"The US Surgeon General's report confirms what we know is true: only a comprehensive approach to tobacco control will bring down smoking rates across the country, and here in New York City," said Sheelah A. Feinberg ,the Director of the NYC Coalition for a Smoke-Free City. "While we have seen a decrease in smoking rates, we still have over 850,000 smokers, many of whom are the most vulnerable populations. We still have much work to do, as we continue to protect the next generation of New Yorkers from the harmful effects of tobacco use and secondhand smoke."

Benjamin did not point fingers on why youth tobacco use continues in the U.S. Instead, she wants to see how the nation as a whole can best address the issue, she said.

"I don't want to focus on blame, I want to focus on prevention," she said. "I want to make sure we're doing everything that we can to prevent kids from ever starting to smoke or use tobacco products."

The surgeon general's office last issued a report on youth tobacco use in 1994, the first wide-ranging report on the topic by federal health officials. The new report is the 31st issued by U.S. surgeons general to warn the public about tobacco's risks. The first report in 1964 declared tobacco to be deadly.

Since the 1994 report, smoking among high school students has declined from 27.5 percent to 19.5 percent, or about 3 million students, but the rate of decline has slowed in recent years. About 5.2 percent, or 600,000 middle school students also are current smokers. According to the report, every day in the U.S., more than 3,800 people under the age of 18 smoke their first cigarette and more than 1,000 of them become daily smokers. They replace the 1,200 people who die each day in the U.S. from smoking.

"Too many of our children are addicted, too many cannot quit, and too many go on to die far too young," Assistant Secretary for Health Howard Koh said at a news conference today.

The report also examined advertising and promotional activities by tobacco companies, which have been shown to "cause the onset and continuation of smoking among adolescents and young adults."

Tobacco companies have spent increasing amounts of money on marketing efforts to reduce prices, which health officials said in the report could influence access to price-sensitive youth and make cigarettes more affordable.

"Far too many kids still see smoking images and messages every day that normalize this dependence," Koh said. "Kids see smoking in the movies they watch, the video games they play, the websites they visit and in the communities where they live."

Nearly $10 billion was spent in 2008 on cigarette marketing by the nation's biggest tobacco companies, a 48 percent increase from what was spent in 1998, when some of the companies agreed with state attorneys general to curtail or stop some of their marketing efforts. That 25-year, $206 billion settlement also pays states for smoking-related health care costs and to support tobacco prevention and cessation programs.